The purpose of this has been to develop and test the psychometric properties of instruments to measure the following aspects of the experience of family caregivers: caregiver involvement in providing care, reactions to caregiving (burdens, financial consequences, effects on employment, physical and mental health and social functioning); and use of health services. In this competing continuation grant, we propose to use these instruments to follow the initial sample of Alzheimer's caregivers (n = 250) at 12 and 24 months after entry into the study to examine how changes in caregiver reactions, involvement in providing care and use of health services over time relate to the changing behavioral symptoms of the Alzheimer's patient and the outcomes of caregiving. Further, we plan to examine caregivers' perceptions of the availability of, need for and barriers to use of community services in order to understand the conditions under which community services are needed and used. We will also administer instruments to caregivers whose patient dies or is institutionalized following entry into the study to determine the effect of these events on caregiver physical, emotional and social well-being. This longitudinal data will provide vital information for the long-term planning of community services for Alzheimer's patients and their families, and, when incorporated with data obtained using similar instruments administered to caregivers of physically impaired and cancer patients, will provide major insights into the roles, reactions, and expenditures of facilities who care for patients in the home.